Provider Demographics
NPI:1073956595
Name:OUTPATIENT SURGERY CENTER OF BEVERLY HILLS
Entity Type:Organization
Organization Name:OUTPATIENT SURGERY CENTER OF BEVERLY HILLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR / OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ASHKAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GHAVAMI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-275-1959
Mailing Address - Street 1:433 N CAMDEN DR
Mailing Address - Street 2:SUITE 1170
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210-4409
Mailing Address - Country:US
Mailing Address - Phone:310-275-1969
Mailing Address - Fax:
Practice Address - Street 1:433 N CAMDEN DR
Practice Address - Street 2:SUITE 1170
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-4409
Practice Address - Country:US
Practice Address - Phone:310-275-1969
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-15
Last Update Date:2013-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical